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Flashcards in Neck and Arm pain Deck (46):
1

What percent of people who develop neck pain will have it chronically?

10%

2

Over what age is a red flag for neck pain?

Over 50

3

Pain lasting greater than how long is a red flag?

one month

4

Neck pain with associated HA, shoulder or hip girdle pain in an older person = ?

Rheumatologic disease

5

Neck pain with a h/o fever, chills, unexplained weight loss = ?

Cancer

6

Neck pain with neurological signs or symptoms (arm clumsiness, gait difficulty, bowel or bladder dysfunction) = ?

Cervical myelopathy

7

A shock-like paresthesia occurring with neck flexion suggesting compression of the cervical cord by a midline disc herniation = ?

Cervical myelopathy

8

What are the neuro signs that should be elicited when evaluating neck pain?

DTRs
UMN testing
Provocative maneuvers

9

The majority of neck pain has what origin?

Muscular

10

What is the degenerative cascade model?

Discogenic conditions (dysfunction phase)
Stenotic phase (stabilization of the chronic SD)

11

What is a sprain?

Injury to the ligament

12

What is a strain?

muscle tendon unit injury

13

What is cervical strain?

Overload injury to the muscle tendon unit of the neck.

14

What is cervical spondylosis?

Degenerative changes in the neck, followed by osteophyte formation

15

How do you diagnose cervical spondylosis?

Cervical x-ray

16

Do x-ray findings for cervical spondylosis correspond well to the pain patients experience

No

17

What are the three common x-ray findings with cervical spondylosis?

-Loss of disc height
-Anterior osteophytes
-Narrowing of the foramina

18

What is degenerative disc disease? What causes it?

Degenerative process causing a loss of disc height, nuclear degradation, and disc bulging

Part of natural aging, but also a consequence of poor nutrition

19

What is internal disc disruption?

When the disc develops a rip or tear, usually caused by cervical trauma

20

What is a herniated nucleus pulposus?

When the nucleus pulposus squeezes out of the vertebrae

21

True or false: degenerative disc disease is a radiologic diagnosis

True

22

What are internal disc disruptions?

symptoms exaggerated with neck helo in one position for prolonged periods

23

What is radicular pain?

When pain shoots down a lumb and courses down a dermatome

24

What is the sign that may be elicited with a cervical disc herniation?

Spurlings sign

25

What areas of the spine are most commonly affected with cervical disc herniation?

C5-C6, followed by C6-C7

26

What are the radiological findings of disc degeneration?

Loss of white coloring
Protrusion into the spinal cord

27

What is the relation of UE pain with neck pain?

Compression of the brachial plexus

28

What is cervical radiculopathy?

nerve root injury in the presence of spondylosis or stenosis

29

What are the ssx of cervical radiculopathy?

Sensory, motor, or reflex abnormalities

30

Which cervical levels are usually affected by radiculopathy?

Lower (C7, C6)

31

What is spinal stenosis?

Progressive narrowing of the central spinal canal

32

What can cause spinal stenosis?

Bulging or protrusion of the intervertebral disc annulus posteriorly

Hypertrophy of spinal ligaments or facet joints

33

What are the primary ssx of spinal stenosis?

Chronic pain
Numbness
Motor weakness

34

UMN occur with spinal stenosis or neural foraminal stenosis?

Spinal stenosis

35

Cervical stenosis is associated with an AP diameter less than what?

Less than 10 mm

36

What are the UMN reflexes like?

Hyperreflexive

37

What is cervical spondylotic myelopathy?

Defined by degenerative changes narrowing the spinal canal

38

What are the ssx of cervical myelopathy?

-Weakness
-Coordination impairment
-Gait disturbances
-Bowel or bladder dysfunction

39

What is thoracic outlet syndrome?

Compression injury or irritation by the brachial plexus

40

What is neurogenic thoracic outlet syndrome?

Brachial plexus is injured

41

What is vascular thoracic outlet syndrome?

Subclavian and/or vein is damaged

42

What is nonspecific thoracic outlet syndrome?

Patients have ssx but no abnormal tests to document the lesion clearly

43

What are the boundaries of the brachial plexus?

Scalenes
Clavicle and first rib
Beneath the pec minor

44

Cervical radiculopathy is most commonly found involving which cervical root? Where would you sensory test for this?

C7
Proximal phalex

45

What are a myofascial trigger points?

Hyperirritable spots in skeletal muscle that respond painfully to stretch and is TTP

46

What is the major etiology of most neck pain?

Biomechanical stress